Provider Demographics
NPI:1174020986
Name:DUNBAR, DANIEL RICHARD
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:RICHARD
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2605
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98907-2605
Mailing Address - Country:US
Mailing Address - Phone:509-454-4143
Mailing Address - Fax:
Practice Address - Street 1:617 SCOON RD
Practice Address - Street 2:
Practice Address - City:SUNNYSIDE
Practice Address - State:WA
Practice Address - Zip Code:98944-1031
Practice Address - Country:US
Practice Address - Phone:509-837-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71931207R00000X
WI71722-20390200000X
WAOP61094156207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program